GRAND AVENUE DENTAL, LLC

SAINT PAUL, MN
NPI1154933661
Entity TypeOrganization
Authorized ContactROBERT S TYLER
Business Manager
651-291-9667
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2020-08-18
Last Update Date2020-08-18
Business Address
GRAND AVENUE DENTAL, LLC
960 GRAND AVE
SAINT PAUL, MN 55105-3014
Phone number: 651-291-9667
Mailing Address
GRAND AVENUE DENTAL, LLC
960 GRAND AVE
SAINT PAUL, MN 55105-3014
Phone number: 651-291-9667
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